冠状动脉造影正常的急性ST段抬高性心肌梗死相关因素分析

南方医科大学学报 ›› 2005, Vol. 25 ›› Issue (05): 577-579.

冠状动脉造影正常的急性ST段抬高性心肌梗死相关因素分析

梁振涛¹, 郭军², 余小平¹, 张斌¹, 张卫星¹, 朱仲生¹, 罗华¹, 黄磊¹

1. 北京大学深圳医院ICU, 广东, 深圳, 518000;
2. 深圳市宝安人民医院心内科, 广东, 深圳, 518000

出版日期:2005-05-20 发布日期:2005-05-20
基金资助:
收稿日期:2004-11-20。
作者简介:梁振涛(1968- ),副主任医师,主要从事冠心病急重症的临床救治与研究,电话:0755-83063235

Factors associated with acute ST-segment elevation myocardial infacrtion with normal angiographic findings of the coronary artery

LIANG Zhen-tao¹, GUO Jun², YU Xiao-ping¹, ZHANG Bin¹, ZHANG Wei-xing¹, ZHU Zhong-sheng¹, LUO Hua¹, HUANG Lei¹

1. 北京大学深圳医院ICU, 广东, 深圳, 518000;
2. 深圳市宝安人民医院心内科, 广东, 深圳, 518000

Online:2005-05-20 Published:2005-05-20

摘要/Abstract

摘要： 目的探讨急性ST段抬高性心肌梗死(STEMI)冠状动脉造影正常病人的相关因素.方法回顾性分析北大深圳医院自2001年1月至2004年10月收治的271例初发STEMI病人的心电图、心脏超声和冠状动脉造影资料,其中STEMI急诊冠状动脉造影正常的病人29例,从其余242例STEMI急诊冠状动脉造影异常的病人中随机抽取60例作为对照组.应用1ogistic回归分析冠状动脉造影正常的STEMI相关因素.结果本组冠状动脉造影正常者STEMI的发生率为10.7%.单因素分析表明,冠状动脉造影正常和异常STEMI病人的性别、高血压、高血脂、平均肌酸肌酶峰值、ST段重新抬高和Q波计数无显著性差异(P>0.05).两组病人年龄、吸烟情况、糖尿病、缺乏梗死前心绞痛、室壁运动积分有显著性差异(P<0.05).多因素分析表明年龄、吸烟、缺乏梗死前心绞痛是冠状动脉造影正常STEMI的相关因素(P<0.05),而糖尿病、高血压、高血脂等冠心病的危险因素与冠状动脉造影正常STEMI没有相关性(P>0.05).住院期间,冠状动脉造影正常的STEMI病人射血分数、心指数、每搏指数和室壁运动积分较冠状动脉造影异常的病人明显改善(P<0.05),心脏病事件少于冠状动脉造影异常的病人(P<0.01).结论冠状动脉造影正常STEMI常见于大量吸烟、缺乏梗死前心绞痛的年轻病人,可能与自发性再灌注有关.

Abstract: Objective To identify the factors related to acute ST-segment elevation myocardial infarction (STEMI) with normal angiographic findings of the coronary artery.Methods An retrospective analysis of the electrocardiographic, echocardiographic, and angiographic data of 271 STEMI cases was conducted. Of these patients, 29 had normal coronary artery by angiography and from the rest patients presenting abnormal angiographic findings of the coronary artery, 60 were randomly selected to serve as the control group. Multiple logistic regression analysis was performed to identify the independent factors related to acute STEMI with normal coronary artery by angiography.Results The incidence rate of STEMI with normal coronary artery was 10.7%. Univariate analysis showed that age, smoking, diabetes mellitus, absence of pre-infarction angina, and wall motion score were related to STEMI with normal coronary artery (P<0.05), whereas multiple logistic regression analysis identified the former 3 factors as the related factors (P<0.05). Wall motion score, left ventricular ejection fraction, cardiac index, and stroke volume index were higher, and cardiac events fewer in patients with normal coronary artery than in those with abnormal coronary artery (P<0.01).Conclusion Acute STEMI with normal coronary artery is more likely to occur in young smokers without pre-infarction angina, possibly in association with spontaneous reperfusion.

中图分类号:

R542.2⁺2

梁振涛¹, 郭军², 余小平¹, 张斌¹, 张卫星¹, 朱仲生¹, 罗华¹, 黄磊¹. 冠状动脉造影正常的急性ST段抬高性心肌梗死相关因素分析[J]. 南方医科大学学报, 2005, 25(05): 577-579.

LIANG Zhen-tao¹, GUO Jun², YU Xiao-ping¹, ZHANG Bin¹, ZHANG Wei-xing¹, ZHU Zhong-sheng¹, LUO Hua¹, HUANG Lei¹. Factors associated with acute ST-segment elevation myocardial infacrtion with normal angiographic findings of the coronary artery[J]. Journal of Southern Medical University, 2005, 25(05): 577-579.

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